Anhylaxis In The Emergency Department Essay

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Anaphylaxis in the Emergency Department
Anaphylaxis is a hypersensitivity reaction and can start immediately after a trigger. Anaphylaxis is common in the emergency department and is considered a medical emergency when symptoms are present. This disorder does not discriminate when it comes to age, gender or race. Reactions commonly occur due to medications, insect stings, aeroallergens and food allergies. This disorder can progress rapidly with multiple reactions throughout the body. Without medical intervention of severe reactions, death can occur. Anaphylaxis can cause contraction of bronchial smooth muscle, laryngeal edema, and vascular collapse which may result in respiratory distress, decreased blood pressure and shock (McCance & Huether,
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This response is initiated by IgE antibodies which in turn leads to mast cell and basophil activation. It is through this activation, you will see a release of certain mediators such as, histamine, serotonin, and leukotrienes. Common causes include medication, such as penicillin. Food allergies, such as nuts, shellfish, seafood and eggs. Anaphylaxis reactions usually are immediate and severe requiring intervention by the Nurse Practitioner. Symptoms develop within five to ten minutes after second exposure to allergen (McCance & Huether, 2014). As mention above, type 1 anaphylaxis reactions are accredited to histamine released within the body. Anaphylaxis involves the widespread release of histamine and other mast cell mediators, resulting in clinical manifestations such as cardio-respiratory compromise (tachycardia, hypotension, wheeze), gastrointestinal muscle contraction (vomiting and/or diarrhea), and skin or mucosal findings (such as urticaria or angioedema) (Burnell,2015). In the emergency department, clinical presentation and history of the patient will aid with the diagnose of anaphylaxis. Although, the use of tryptase and histamine blood levels have been used after the onset of symptoms within hours of anaphylaxis in some settings. Typically, this is not standard practice for diagnosing anaphylaxis …show more content…
According to the author, “anaphylaxis occurs when the exposure to a suspected or known trigger causes systemic release of histamine and other mediators of allergic inflammation that lead to a varying constellation of potentially life-threatening allergic symptoms” (Burnell, 2105). The author however, did not go into detail regarding the pathophysiology. The author addressed briefly the disorder but in regards to the cellular level, and how anaphylaxis occurs, this information was omitted from the journal. The underlining reason the author did not go into detail regarding the pathophysiology is vague. The author addressed other information pertinent to anaphylaxis which includes prevalence, etiology, triggers, risk factors, clinical manifestations, emergency medical services, treatment and discharge of the patient. Although these are important topics, pathophysiology should have been addressed in detail to have a clear understanding of anaphylaxis and what happens throughout the body. Also statistics addressed in this journal, did not involve the United States. According to Clark statistics in the United States, “Every 3 minutes a food allergy reaction sends someone to the emergency department– that is about 200,000 emergency department visits per year, and every 6 minutes the reaction is one of anaphylaxis” (Clark, 2011). This statistic identifies anaphylaxis as a

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